Oral Anticoagulant Use Among Residents in VA Long-Term Care With Atrial Fibrillation After the 2014 ACC/AHA Guideline.
Veena Manja, Yongmei Li, Michael A Steinman and 7 others
PMID 42648009WHAT IT FOUND
Anticoagulant use, adjusted for age, rose from 31.2% in 2013 to 2014 to 46.6% in 2019 among high-risk VA nursing home residents with AF, but use was lower in older, Black, Hispanic, and functionally or cognitively impaired residents.
Key findings
01In the first 4 weeks, 28.7% received aspirin alone, 40.8% received an anticoagulant with or without aspirin, and 30.5% received neither.
02Age-standardized use of an anticoagulant with or without aspirin increased from 31.2% in 2013 to 2014 to 46.6% in 2019.
03Older age, Black race, Hispanic ethnicity, cognitive impairment, and greater daily-activity limitation were associated with lower anticoagulant or aspirin use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done only in VA nursing homes and almost all residents were male, so the medication patterns may not apply to other nursing home populations. The analysis did not include patient preferences, goals of care, or provider assessment of life expectancy and risks, so lower anticoagulant use in some groups may reflect deliberate clinical judgment rather than a care gap. The study measured medication receipt and associations, not treatment benefit.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not read the rise to 46.6% as proof that anticoagulation helped these residents. The study measured medication use and associations, not treatment benefit.